血清睾酮水平和前列腺癌病理分级及术后病理升级的相关性研究

Association between low serum testosterone and prostate cancer grade or Gleason Score upgrading

目的：探讨行前列腺癌根治术患者血清睾酮水平与其病理分级的关系,以及与根治术后病理升级的相关关系。方法：回顾性研究2013年1月-2014年12月期间于我中心行腹腔镜下前列腺癌根治术的135例患者,收集患者年龄、体质指数（BMI）、前列腺特异性抗原（PSA）、血清睾酮水平及合并伴随疾病等资料,记录患者穿刺病理Gleason评分及根治病理Gleason评分。结果：低睾酮（〈300ng/dl）组的穿刺病理Gleason评分明显高于正常睾酮（≥300ng/dl）组（P=0.02）,低睾酮组的根治病理Gleason评分同样也明显高于正常睾酮组（P〈0.01）。低睾酮组有20例（45.5%）出现病理升级,而在正常睾酮组有25例（27.5%）出现病理升级,低睾酮组发生根治术后病理升级明显多于正常睾酮组（P=0.04）。结论：临床上较低的睾酮浓度往往预示着更高级别前列腺癌并且同样预示着更易出现前列腺癌根治术后的病理升级,在治疗方式的选择上应当予以重视。

Objective：To investigate the association between serum testosterone and biopsy or pathological Gleason Score（GS）,and to assess the relationship between testosterone and GS upgrading after radical prostatectomy.Method：We retrospectively assessed 135 patients who were diagnosed as prostate cancer（PC）by biopsy and treated with laparoscopic radical prostatectomy（LRP）from January 2013 to December 2014 in our medical center.Age,BMI,PSA,total testosterone and comorbidities of patients were measured.Biopsy GS and pathological GS were collected.Result：Low serum testosterone was associated with a higher biopsy GS（P =0.02）and also a higher pathological GS（P〈 0.01）.Meanwhile,a low serum testosterone predicted a higher possibility of GS upgrading after prostatectomy（P =0.04）.Conclusion：Low serum testosterone predicts a higher biopsy GS,pathological GS and a higher possibility of GS upgrading after prostatectomy.We should pay attention to it when choosing therapies.